DR. JAY WILKINSON (NPI# 1497809164) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497809164 |
| Entity Type | Individual |
| Full Name | DR. JAY WILKINSON |
| Credential | PSY.D. |
| Practice Address |
1700 Nw Civic Dr Suite 310 Gresham OR 97030-3770 |
| Mailing Address |
6704 Se 75th Ave Portland OR 97206-7248 |
| Practice Telephone | 5036668832 |
| Mailing Telephone | 5034321458 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2012-01-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
2159 | OR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
2159 | OR | Behavioral Health & Social Service Providers |
| Street Address |
1700 NW CIVIC DR SUITE 310 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447336037 | Kerry E M Phifer | Nurse Practitioner | 1700 Nw Civic Dr, Suite 301, Gresham, OR 97030-3770 | 2006-10-27 |
| 1407251408 | Nicklaus Clark | Counselor | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2014-11-03 |
| 1346645777 | Patricia Bootzin | Counselor | 1700 Nw Civic Dr, Sutie 310, Gresham, OR 97030-3770 | 2014-10-28 |
| 1255741773 | Sarah Dangaran | Behavioral Analyst | 1700 Nw Civic Dr, 310, Gresham, OR 97030-3770 | 2014-05-06 |
| 1063761716 | Clark Paul Rector | Psychologist | 1700 Nw Civic Dr, Gresham, OR 97030-3770 | 2012-09-09 |
| 1235493743 | Kathleen Suzanne Leavitt | Marriage & Family Therapist | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2012-06-28 |
| 1144453051 | Valerie Ann Reynolds | Counselor | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2009-08-26 |
| 1447485594 | Kristen Peterca | Counselor | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2009-05-19 |
| 1134370265 | Ronn Jeffry Nelson II | Psychologist | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2008-10-07 |
| 1083814677 | Timothy Gazdziak | Counselor | 1700 Nw Civic Dr, Suite 310, Gresham, OR 97030-3770 | 2007-07-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245554567 | Ryan Lee Skelton | Psychologist | 123 E Powell Blvd, 305, Gresham, OR 97030-7624 | 2010-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457771354 | Ana Snegireff | Psychologist | 4722 Oak Park Dr Ne, Salem, OR 97305-2928 | 2014-04-18 |
| 1740616325 | Kathleen Gregorich Hoffman | Psychologist | 3245 Nw Thurman St, Portland, OR 97210-1224 | 2013-09-16 |
| 1558708461 | Anthony Michael Duncan | Psychologist | 2236 Se Belmont St, Portland, OR 97214-2817 | 2013-05-31 |
| 1811253461 | Britania Latronica | Psychologist | 10117 Se Sunnyside Rd # F1217, Clackamas, OR 97015-7708 | 2012-04-09 |
| 1285904094 | Susan J Mcpherson Phd PC | Psychologist | 975 Willagillespie Rd Ste 202, Eugene, OR 97401-2104 | 2012-01-10 |
| 1174813539 | Robert W Mclellarn, Phd | Psychologist | 5440 Sw Westgate Drive, Suite 175, Portland, OR 97221 | 2011-04-19 |
| 1346574449 | Jerusha Beth Detweiler-bedell | Psychologist | 5440 Sw Westgate Dr., #175, Portland, OR 97221-2436 | 2009-09-23 |
| 1386845048 | Morris Tiktin | Psychologist | 1201 Sw 12 Ave, Suite 300, Portland, OR 97205-2046 | 2007-05-30 |
| 1235341629 | Muriel D. Lezak | Psychologist | 2211 Sw 1st Ave, G10, Portland, OR 97201-5060 | 2007-05-05 |
| 1952528952 | Melisa L. Finch | Psychologist | 10201 Se Main St Ste 10, Portland, OR 97216-2937 | 2007-04-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. JAY WILKINSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.